Induced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.
OBJECTIVE
The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability.


METHODS
Twenty ASA I patients, between 17 and 44 years of age who had dental and skeletal deformities were subdivided into 2 groups: group I (clonidine associated to remifentanil), and group II (dexmedetomidine associated to isoflurane), in addition, other drugs were common to both groups. The following responses were assessed: arterial blood pressure, heart rate, temperature during intra- and postoperative periods, incidence of nausea and vomiting, postoperative pain, awakening time, extubation time, and postanesthetic recovery time.


RESULTS
The results of the study using Repeated Measures Test statistical analysis showed that there were no significant differences between the 2 groups in respect to physiologic responses or surgery time.


CONCLUSIONS
Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.
Farah
Gustavo Jacobucci
GJ
Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil. gujfarah@uol.com.br
de Moraes
Márcio
M
Filho
Liogi Iwaki
LI
Pavan
Angelo José
AJ
Camarini
Edevaldo Tadeu
ET
Previdelli
Isolde T S
IT
Coelho
Luciano
L
D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage; D000328:Adult; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D003000:Clonidine / Q000008:administration & dosage; D020927:Dexmedetomidine / Q000032:analysis; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007023:Hypotension, Controlled / Q000379:methods*; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D019647:Oral Surgical Procedures; D010880:Piperidines / Q000008:administration & dosage; D000077208:Remifentanil
D000316:Adrenergic alpha-Agonists; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D020927:Dexmedetomidine; D007530:Isoflurane; D003000:Clonidine; D000077208:Remifentanil